Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section

We present a thirty-six-year-old woman with a high risk pregnancy, complicated by multiple congenital anomalies, severe hyperemesis, a pulmonary embolus, and a large intramural fibroid. This fibroid grew in size during the pregnancy. At 34 + 5 weeks, there were reduced fetal movements and a patholog...

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Main Authors: Balvinder Sagoo, Ka Ying Bonnie Ng, G. Ghaleb, Heather Brown
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2015/640570
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author Balvinder Sagoo
Ka Ying Bonnie Ng
G. Ghaleb
Heather Brown
author_facet Balvinder Sagoo
Ka Ying Bonnie Ng
G. Ghaleb
Heather Brown
author_sort Balvinder Sagoo
collection DOAJ
description We present a thirty-six-year-old woman with a high risk pregnancy, complicated by multiple congenital anomalies, severe hyperemesis, a pulmonary embolus, and a large intramural fibroid. This fibroid grew in size during the pregnancy. At 34 + 5 weeks, there were reduced fetal movements and a pathological CTG. A live infant was delivered by an emergency cesarean section. Five weeks postpartum, she presented with abdominal pain, offensive vaginal discharge, and fevers. She was given antibiotics and ferrous sulphate. An abdominal ultrasound showed an 11 × 12 × 9 cm fibroid with a coarse degenerative appearance. Clinically, she showed signs of sepsis; a CT scan and laparotomy performed under general anesthetic did not find any collections as a source of sepsis. When stable, she was discharged. She re-presented two days later with a large mass (necrotic fibroid) in her vagina. This is the first case of spontaneous expulsion of fibroid six weeks after caesarean section. Presentation of pain and fever after the delivery may be due to red degeneration of the fibroid, caused by diminished blood supply, ischaemia, and necrosis. This case highlights the importance of considering fibroids as a cause for abdominal pain during and after pregnancy, even up to 6 weeks after delivery.
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spelling doaj-art-8ea8e367953e42d08110d781e846a7232025-08-20T03:37:16ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922015-01-01201510.1155/2015/640570640570Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean SectionBalvinder Sagoo0Ka Ying Bonnie Ng1G. Ghaleb2Heather Brown3Department of Obstetrics & Gynaecology, London North West Healthcare NHS Trust, UKDepartment of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, UKDepartment of Obstetrics & Gynaecology, Worthing and Southlands Hospital NHS Trust, UKDepartment of Obstetrics & Gynaecology, Worthing and Southlands Hospital NHS Trust, UKWe present a thirty-six-year-old woman with a high risk pregnancy, complicated by multiple congenital anomalies, severe hyperemesis, a pulmonary embolus, and a large intramural fibroid. This fibroid grew in size during the pregnancy. At 34 + 5 weeks, there were reduced fetal movements and a pathological CTG. A live infant was delivered by an emergency cesarean section. Five weeks postpartum, she presented with abdominal pain, offensive vaginal discharge, and fevers. She was given antibiotics and ferrous sulphate. An abdominal ultrasound showed an 11 × 12 × 9 cm fibroid with a coarse degenerative appearance. Clinically, she showed signs of sepsis; a CT scan and laparotomy performed under general anesthetic did not find any collections as a source of sepsis. When stable, she was discharged. She re-presented two days later with a large mass (necrotic fibroid) in her vagina. This is the first case of spontaneous expulsion of fibroid six weeks after caesarean section. Presentation of pain and fever after the delivery may be due to red degeneration of the fibroid, caused by diminished blood supply, ischaemia, and necrosis. This case highlights the importance of considering fibroids as a cause for abdominal pain during and after pregnancy, even up to 6 weeks after delivery.http://dx.doi.org/10.1155/2015/640570
spellingShingle Balvinder Sagoo
Ka Ying Bonnie Ng
G. Ghaleb
Heather Brown
Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section
Case Reports in Obstetrics and Gynecology
title Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section
title_full Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section
title_fullStr Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section
title_full_unstemmed Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section
title_short Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section
title_sort spontaneous expulsion of intramural fibroid six weeks after emergency caesarean section
url http://dx.doi.org/10.1155/2015/640570
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AT gghaleb spontaneousexpulsionofintramuralfibroidsixweeksafteremergencycaesareansection
AT heatherbrown spontaneousexpulsionofintramuralfibroidsixweeksafteremergencycaesareansection